Flag Order Request Form
Directions: Please print this order request and mail it with your check to the address below!
Flag Purchased By:
|
Send Flag To Mailing Address:
|
|
|
|
|
|
|
, |
, |
|
|
E-mail: |
E-mail: |
Phone: |
Phone: |
Size |
Material |
Quantity Flown Over the Capitol |
Quantity NOT Flown Over the Capitol |
3'x5' |
Nylon |
@ $19.00 |
@ $14.00 |
3'x5' |
Cotton |
@ $20.00 |
@ $15.00 |
4'x6' |
Nylon |
@ $24.00 |
@ $19.00 |
5'x8' |
Nylon |
@ $29.00 |
@ $24.00 |
5'x8' |
Cotton |
@ $32.00 |
@ $27.00 |
|
|
Subtotal: $0.00 |
Subtotal: $0.00 |
Order Total: $ |
For flags flown over the U.S. Capitol, please use the following information for the certificate, or for multiple flags, use the names and occasions as specified on the attached, user-provided document.
Flag will be presented to (name as it should appear on the certificate):
Special occasion:
Requested date for flag(s) to be flown:
Please submit your request at least 6 weeks ahead of your desired date. Payments must be made by check, payable to The Keeper of the Stationary.
Checks MUST be for the EXACT amount above, to expedite the process!
Mail the form and payment to:
Senator Tim Scott
Attn: Flag Coordinator
167 Russell Senate Office Building
Washington, DC 20515
Phone: (202) 224-6121
Fax: (202) 228-5143
For Office Use Only: |
Received Request: |
__________ |
Received Check: |
__________ |
Deposited Check: |
__________ |
To Flag Office: |
__________ |
From Flag Office: |
__________ |
Mailed Flag(s): |
__________ |
|
Click here to edit your order.
Purchase a U.S. flag through my office. There is no limit on the number of flags you may order. You may also request that your new flag be flown over the Capitol for an additional charge. Flags may be flown for a particular person, event, or organization, and may be flown on a specific date. A certificate of recognition is included with each flag.